Family Caregiving of Older People with Dementing Illnesses in Nursing Homes: a Lifeline of Special Care

Abstract

Objective: Explore the meaning of the care given by family caregivers to family members with a dementing illness after their placement in a nursing home. Method: A constructivist approach, informed by symbolic interactionism, and using grounded theory methods, served as the theoretical and analytical underpinnings of this study. In all, 14 family caregivers (predominantly daughters caring for mothers) were interviewed. Results: There is a dual meaning inherent in family caregiving activities in this context. It is perceived as a lifeline of special care for the family member in the nursing home, and is meaningful and constructive for the caregivers themselves. Conclusion: Understanding this ‘;dual’ meaning of family caregiving activities is highly relevant for health care workers and others who interact with family members in the nursing home situation.

Patterns of Family Visiting With Institutionalized Elders: The Case of Dementia

“…For example, in a comparative study of family caregivers for a relative with dementia at home and those who had placed their relative in a nursing home, Stephens, Kinney, and Ogrocki (1991) found that caregivers visited their institutionalized relatives, on average, 2.9 days per week. Other research demonstrates that a majority of family caregivers visit relatives living in nursing homes at least weekly (Bitzan & Kruzich, 1990;Fleming, 1998;Hook, Sobal, & Oak, 1982). Some studies find length of residence is negatively correlated with the frequency of visits (e.g., Bitzan & Kruzich, 1990;Green & Monahan, 1982;Hook et al, 1982), but other studies find no association (e.g., Minichiello, 1989).…”

“…Similarly, continuing family involvement seems to benefit the quality of life of institutionalized elderly persons, either by improving psychological functioning (Green & Monahan, 1982), or by assuring the quality of institutional care (Fleming, 1998). For example, Green and Monahan (1982) found that elderly persons with frequent family visits had lower levels of psychosocial impairment, suggesting that these visits had a significant therapeutic influence.…”

“…The purpose and meaning of visiting included "maintaining continuity of self and the pattern of daily life, demonstrating commitment, expressing attachment, coping with grief and loss, and avoiding loneliness" (p. 201). Fleming (1998) linked meaning to the construction of self and to a "lifeline of special care." Smith and Bengtson (1979) suggested that some family-elder dyads experienced "renewed closeness" after institutionalization because relief from some burdens facilitated socioemotional interactions.…”

“…Despite the prevailing myth that caregiving ends with placement in a nursing facility, family members typically continue their caregiving activities after institutionalization (Aneshensel, Pearlin, Mullan, Zarit, & Whitlatch, 1995;Bowers, 1988;Dempsey & Pruchno, 1993;Fink & Picot, 1995;Fleming, 1998;Kellet, 1998;Minichiello, 1987Minichiello, , 1989Smith & Bengtson, 1979;Stull, Cosbey, Bowman, & McNutt, 1997;York & Calsyn, 1977;Zarit & Whitlatch, 1992). For example, in a comparative study of family caregivers for a relative with dementia at home and those who had placed their relative in a nursing home, Stephens, Kinney, and Ogrocki (1991) found that caregivers visited their institutionalized relatives, on average, 2.9 days per week.…”

“…On the other hand, continued family relationships often have significant meaning to family members (Fleming, 1998;Kellet, 1998;Tilse, 1997). Tilse (1997) conducted a qualitative content analysis of interview data from 18 Australian spousal caregivers, finding that visiting was embedded in the long-term relationship between the caregiver and their husbands or wives.…”